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This is VAERS ID 61525

Case Details

VAERS ID: 61525 (history)  
Form: Version 1.0  
Age: 11.0  
Sex: Female  
Location: Texas  
Vaccinated:1993-06-08
Onset:1993-06-10
   Days after vaccination:2
Submitted: 1994-03-30
   Days after onset:293
Entered: 1994-04-04
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 3C51048 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1503V / 2 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Abdominal pain, Anxiety, Asthenia, Depression, Headache, Infection, Migraine, Photosensitivity reaction
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Lorabid
Current Illness:
Preexisting Conditions: Thoracic outlet synd; UTI, recurrent; Rhinitis, allergic; chickenpox; strep throat; reglan allergy;
Allergies:
Diagnostic Lab Data: 16JUN93 Serum alk phos 217; Phosphate 4.9; WBC Count 5.6; Neutrophils 40%; Lymphocytes 51%; Monocytes 6%; EOS 2%; Basophils 1%; ESR 18%; Epstein-barr antibody 69%; Lymphocytes 50%; 25AUG93 Epstein-barr 96%; IGA 45%;
CDC Split Type: WAES93090874

Write-up: Pt recvd vax & devel lightheadedness, n&v, h/a, light sensitivity; episode of diarrhea & dec appetite; fever 101, alk phos 217; culture of sinuses revealed 4+ staphylococcus aureus; migraine h/a w/tension component; depressed; hypoglycemia;


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